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Gout on CT of the feet: A symmetric arthropathy
Author(s) -
Doyle Anthony J,
Dalbeth Nicola,
McQueen Fiona,
Boyer Lucinda,
Dong Jing,
Rome Keith,
Frecklington Mike
Publication year - 2016
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12419
Subject(s) - medicine , gout , arthropathy , bone erosion , rheumatoid arthritis , metatarsophalangeal joints , significant difference , arthritis , radiology , nuclear medicine , surgery , pathology , osteoarthritis , alternative medicine
The aim of this study was to assess the distribution of bone erosions in the feet of patients with gout using CT and thereby to test the hypothesis that gout is an asymmetric arthropathy. Methods CT scans of both feet were obtained from 25 patients with chronic gout. CT scans were scored for bone erosion using a semi‐quantitative method based on the rheumatoid arthritis MRI scoring system ( RAMRIS ). CT bone erosion was assessed at 22 bones in each foot (total 1,100 bones) by two independent radiologists. Symmetry was assessed by two methods: (i) comparing right and left foot scores for each patient; and (ii) calculating the proportion of paired joints with or without erosions. Results Observer agreement was excellent (intra‐class correlation coefficient 0.92). In the group overall, the difference in scores between the feet was not significant ( S tudent's t ‐test P = 0.8). In 17 of 25 patients, the difference in erosion scores between the two feet was less than the inter‐observer difference. In 24 of 25 patients, the proportion of paired joints was greater than 0.5, indicating symmetric disease. Conclusions Erosive disease from gout is, in fact, a symmetric process in our patient group. This finding is contrary to the established view of gout as an asymmetric arthritis and lends new insight into the behaviour of this common disease.